Contralateral Tension Pneumothorax during One Lung Ventilation by a Univent(R) Tube / 영남의대학술지

Tension pneumothorax during one-lung ventilation (OLV) is a rare but life-threatening complication. A 79-year-old male patient who was diagnosed with lung cancer underwent Univent(R) Tube (Fuji Systems Corporation, Tokyo) intubation for left upper lobectomy. Two hours after the initiation of OLV, the patient could not tolerate it. Thus, oneand two-lung ventilation were alternatively applied to continue the operation. After the operation, an emergent chest radiograph was taken, and pneumothorax was found at the right (dependent) lung field.

Aspiration Pneumonia at Recovery Room in the Patient Emergency Pelviscopic Salpingectomy, without the Perceptive Sign of Gastric Regurgitation during Perioperative Periods: A case report / 대한마취과학회지

Aspiration pneumonia is considered to be a morbid complication of anesthesia, It was reported that several conditions are associated with an increased frequency of aspiration pneumonia, such as gastroenterological, neurological and, pulmonary diseases. The incidence is also higher in emergency situations than during elective surgery. We encountered aspiration pneumonia after emergency laparoscopic salpingectomy. The patient was 25 years old woman with no prior medical history but had fasted for only 5 h in the preoperative period. During the perioperative period, there were no signs of regurgitation of the gastric contents into the oral cavity. After surgery, the patient was transported to the recovery room in a fully awakened state. However, the patient became cyanotic without vomiting. After physiotherapy, a chest CT scan was performed, and she was diagnosed with aspiration pneumonia. She was admitted to intensive care. Ten days later, she was discharged in a healthy state.

Effects on Renal Functions of Low Dose Dopamine in Partial Hepatectomy Patients / 대한마취과학회지

BACKGROUND: Low dose dopamine is widely used during the perioperative period to preserve renal perfusion. Low dose dopamine (3-5 microgram/kg/min) was administrated to partial hepatectomy patients and BUN, creatinine in serum were measured to determine the effects of low dose dopamine on renal function. METHODS: Liver group (n = 28) were administered low dose dopamine (3-5 microgram/kg/min) and the stomach group (n = 23) were not administered any vasoactive drugs during the operation. Perioperative plasma BUN, and creatinine, creatinine clearance, BUN/creatinine ratio, serum Na+ and K+, and central venous pressure (CVP) were checked 3 times, just after starting operation, 4 hours after starting the operation, and at PACU for both groups. We also evaluated intravascular volume status using the CVP and the BUN/creatinine ratio. Changes in BUN, and creatinine level during the operation in both group were compared. All the patients in this study were confirmed as having euvolemia by CVP and BUN/creatinine ratio. RESULTS: Urine volume increased significantly in the liver group with low dose dopamine compared to the stomach group (P < 0.05). The BUN level in the liver group increased significantly versus the stomach group (P < 0.05). In both groups, the creatinine level increased significantly (P < 0.05) and the plasma Na+ level decreased significantly (P < 0.05). CONCLUSIONS: We confirmed that low dose dopamine significantly increases urine volume in euvolemia status cases during liver surgery. But we were unable to determine why increased diuresis by the administration of low dose dopamine during operation and has a renal protective effect.

Comparing the Analgesic Effect between Continuous Intravenous Infusion of Fentanyl with Clonidine and Fentanyl Only after Cesarean Section / 대한마취과학회지

BACKGROUND: Clonidine, alpha2-adrenoreceptor agonist, has nonopiate antinociceptive properties, which might be an alternative for postoperative analgesia free of opioid induced side effects. The aim of this study was to evaluate the fentanyl sparing effect of clonidine and reducing side effects with intravenous administration. METHODS: Fourty seven patients undergoing a cesarean section were randomly allocated to two groups to be given the following agents by intravenous administration. Group I, fentanyl 0.2ng/kg/h with clonidine 0.2ng/kg/h for 72 h adding normal saline for a total of 150 cc. Group II, fentanyl 0.4ng/kg/h for 72 h adding normal saline for a total of 150 cc and analgesia was provided intravenously via patient -controlled analgesia (PCA; basal rate = 2 ml, rescure dose = 1 ml, lock-out time = 10 min). Postoperative analgesia was assessed by VAS at 2, 4, 8, and 24 h after extubation. In addition, we also checked the vital sign sedation score. RESULTS: There were no differences of VAS scores, hemodynamic values except systolic pressure (P < 0.05), or side effects between group I and group II. The frequency of nausea was 8.7% in group I and 29% in group II, and dizziness was 4.3% in group I and 8.3% in group II. CONCLUSIONS: Intravenous clonidine with narcotics is a possible approach to postoperative pain management in patients recovering from major surgery, especially spine surgery, and clonidine spares and reduces side effects in narcotics.